Organization
KEHLANI CARES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY D FUENTES (OWNER)
(734) 307-5378
Entity
Organization
Contact information
Practice address
1824 15TH ST, WYANDOTTE, MI 48192-3616
(734) 307-5378
(734) 638-6005
Mailing address
14000 DIX TOLEDO RD UNIT 1311, SOUTHGATE, MI 48195-9513
(734) 307-5378
(734) 638-6005
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
177F00000X
Lodging Provider
—
—
225700000X
Massage Therapist
—
—
251E00000X
Home Health Agency
—
—
3747A0650X
Attendant Care Provider
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
03/24/2021
Last updated
03/30/2021
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